Good eyelid hygiene prevents styes

By Andrea K. Walker, The Baltimore Sun

Wear eye makeup to bed or don't wash your face well and you may wind up with pimple-like styes on your eyelids. The bumps don't typically lead to vision loss, but can cause scarring if not treated. Dr. Karen Dunlap, assistant professor of ophthalmology at The Wilmer Eye Institute at Johns Hopkins, said that it is easy to prevent eye styes.

A stye, also known as an external hordeolum, is a localized infection in one of the oil glands at the edge of the eyelid. In many ways it resembles a common pimple, with the infection leading to an inflamed, red and sore bump visible on the lid. External styes occur in the glands of Zeis or Moll, which are glands associated with the eyelash follicle that secrete a lipid component of the tear film through the follicle. There are also internal hordeola, which show up as slightly deeper and often more painful localized inflammation of the lids, and occur in another one of the tear's oil glands called the meibomian gland.

What causes a stye to form?

Styes are typically caused by bacteria, most commonly Staphylococcus. Staphylococcus is normally present in the natural bacterial flora in the eye, but in the case of a stye, it proliferates and causes an inflammatory reaction. Stye formation is spontaneous, although it can be associated with poor lid hygiene or an underlying condition such as blepharitis or acne rosacea. It can also be caused by systemic infections.

Styes typically resolve spontaneously in a few days by breaking open naturally and draining. However, there are a number of remedies that may aid in the healing process. One common and effective way to treat a stye is to apply warm compresses multiple times a day for 5 to 10 minutes to the affected eyelid. This softens the granuloma to facilitate drainage. Cleansing the lid margins with a mild soap or baby shampoo is also a helpful home remedy. If the stye comes to a head and opens, gently massaging the lid margins can also be beneficial in expelling some of the contents of the infected gland, although squeezing the stye vigorously or prematurely could potentially worsen the inflammation and cause the bacteria to spread. Removing the affected eyelash by an eye care professional may also accelerate healing. Over-the-counter or prescription topical antibiotic eye ointments are also available to speed the natural recovery by fighting the infecting bacteria, and can also prevent secondary eye surface irritation and infection. Bacitracin and tobramycin are common antibiotics used in these preparations. Often times the ointment preparations also include a mild steroid, such as dexamethasone, which reduces inflammation and pain.

When should someone seek an eye care professional for treatment of a stye?

If burning, crusting, redness and/or blurred vision occur in the eye itself, the bacteria draining from the stye could be causing a secondary ocular infection, and medical attention should definitely be sought. If inflammation from the stye spreads deeper, especially if it starts to involve the entire eyelid or even both eyelids, this could represent a much more serious infection called preseptal cellulitis which would require an oral antibiotic. If left untreated, these deeper infections could potentially progress to the entire bone around the eye, or orbit. Seeking consultation with an eye care professional is essential in any of these cases. There can also be a hard bump in the lid left behind after the active infection in the stye clears, which is called a chalazion. These bumps consist of blocked up oils and dead skin cells, and are generally painless. They could remain for weeks or months, with very persistent ones sometimes requiring removal by an ophthalmologist using a small incision into the lid.

Are there ways to prevent styes?

Keeping the eyelids and lashes clean is the best way to avoid stye formation. Some individuals are more prone to styes than others, especially if they have underlying skin or other medical conditions such as acne rosacea or blepharitis. Using old makeup, such as mascara, eyeliner and even foundation, can put an individual at higher risk, so replace these frequently. Failure to cleanse the face and lids, and failure to remove eye makeup before bedtime also promote stye formation. If any crusting or redness is visible at the edges of the lid, performing good lid hygiene with warm compresses and lid scrubs may help prevent styes. Massaging the lid margins to express clogged contents in the glands may also be necessary in some individuals for stye prevention, especially if your skin is naturally oily.

Can a stye lead to blindness or other serious eye problems?

Styes themselves are generally not vision-threatening and will mostly resolve on their own without complication. However, chronic styes can potentially cause scarring and disfigurement of the lids over time. Any stye infection that spreads to deeper tissues and involves swelling of the entire lid and orbital area can also be vision-threatening and even life-threatening, in which case immediate consultation with a professional is necessary.

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